Ayushmann Khurrana in Shubh Mangal Saavdhan may have tried to make erectile dysfunction (ED) a regular conversation, but for Indians, there's a long, long way to go before this apparent secret is no longer a taboo. For many men, the failure to have an erection becomes an ego issue. Since the penis is shamed for being flaccid, for not being erect for too long, for its size, ED is linked to the perception of 'failed' masculinity. Therefore, most Indian men prefer to hide and do not seek medical treatment.
Kolkata based Dr.Anjan Das, who has over 23 years of experience in urology including uro-oncology and reconstructive urology said that ED can result in unconsummated marriages, couples divorces and broken homes. "It's unfortunate because it's a condition that can be easily treated," he said. The doctor said that the condition, a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity, can have a devastating effect on the family and therefore the community at large.
"But if couples are willing to talk about it, the doctor can prescribe the right treatment and the right lifestyle changes to help manage and resolve the condition," he said.
Dr Das pointed out that it is the inability to understand that an erection is as much emotional response as it is a physical reaction that makes it a taboo. "It's dependent on many physiological factors like blood vessels and the nervous system for example. Sexual stimulation and emotion must work together for a man to get an erection. Therefore, erectile dysfunction, which is a condition where a man is unable to get or maintain an erection, can be treated. But treatment must address the root cause of the condition,” he added.
Men who have ED generally tend to shy away from accepting that they have a problem. They tend to start avoiding intimacy completely and find excuses. In turn, they end up externalizing their frustrations on their respective partners and jeopardize their relationships.
The doctor pointed out that women, too, are affected by ED as they internalize these feelings and their partner’s frustration or lack of interest. They tend to blame themselves and feel they are no longer attractive to their partner or worse still that their partners are cheating on them. In some cases, the women end up body shaming themselves, causing harm to their physical and emotional wellbeing.
Very often, it is the wife or even the father-in-law who approaches the doctor before the man does. Families today are more supportive and more interested in looking for a solution rather than placing the blame on the man. However, there's much more awareness needed.
“Women are no longer shy and are willing to help and support their husbands through the treatment of the condition. Treatment means that marriages can be consummated or couples can once again enjoy a satisfactory sex life, which improves their overall mental and emotional health and well-being,” said Dr Das.
Psychologists believe that ED greatly but subtly disturbs the balance and harmony within a conjugal relationship. In therapy, women are commonly seen to be either expressing suspicion about their partner or indulging in negative self-criticism. “Sadly women are quick to blame themselves. ED is viewed as a sexual disorder by many men and women. The truth is a plethora of other underlying physical as well as psychological conditions which can precipitate an ED in men,” Says Sharmista Mukherjee, clinical psychologist, Calcutta Medical Research Institute.
Mukherjee said that when the man suffers from erectile dysfunction, a woman can experience acute distress. Among others, a lack of education about the causes of ED are frequently behind a woman's self-blame and her feelings of fear, and anxiety. "Feeling hurt and angry as men shy away from sharing their thoughts further adds to their pain and helplessness," she added.
It is not uncommon and it may be linked to medical conditions such as diabetes, high cholesterol and ischemic heart disease (IHD). An ED diagnosis can result in a man getting the right treatment for these conditions as well, which can help to prolong his life and ensure he stays physically healthy.
In the last 5 years, things have changed, as more men in India have approached doctors to treat ED. However, doctors are hoping more people come out of the closet and speak to their families for support as they seek medical help.